Randomized Comparison of a Nicotine Inhaler and Bupropion for Smoking Cessation and Relapse Prevention

Croghan, Ivana T.; Hurt, Richard D.; Dakhil, Shaker R.; Croghan, Gary A.; Sloan, Jeff A.; Novotny, Paul J.; Rowland, Kendrith M.; Bernath, Albert; Loots, Mary L.; Le-Lindqwister, Nguyet A.; Tschetter, Loren K.; Garneau, Stewart C.; Flynn, Kathleen A.; Ebbert, Larry P.; Wender, Donald B.; Loprmizi, Charles L.
February 2007
Mayo Clinic Proceedings;Feb2007, Vol. 82 Issue 2, p186
Academic Journal
OBJECTIVE: To compare the combination of a nicotine inhaler and bupropion to either treatment alone for initiating smoking abstinence and relapse prevention. METHODS: Smokers were randomized to receive a nicotine inhaler, bupropion, or both for 3 months. At 3 months, smoking-abstinent study participants were randomized to their initial medications or placebo. Participants who were smoking at 3 months were randomized to an alternative treatment regimen or placebo. This study was conducted from July 2001 to January 2003. RESULTS: A total of 1700 smokers were randomized to treatment (phase 1) for 3 months. Among the 941 study participants eligible for randomization to the phase 2 trial, 837 continued in the study. For the phase 2 trial, 405 smoking-abstinent participants were randomized to relapse prevention for 9 additional months, and 432 smokers were randomized to re-treatment for an additional 3 months. At the end of the initial 3 months of treatment (phase 1), 82 (14%) of 566, 145 (26%) of 567, and 194 (34%) of 567 study participants receiving a nicotine Inhaler, bupropion, or both, respectively, were abstinent from smoking. Of the 405 smoking-abstinent participants at the end of 3 months, the bupropion group had more smokers than the placebo group (mean No. of smokers, 1.5 vs 1.1; P<.001), and the nicotine inhaler group had higher smoking abstinence rates at 12 months than the placebo group. Those receiving combination therapy had reduced rates of relapse to smoking for the first 3 months of relapse prevention, but this difference disappeared after the initial 3 months. Of the 432 study participants who were smoking at the end of 3 months and who received an alternative treatment regimen, the 223 smokers initially assigned to a nicotine inhaler were more likely to stop smoking at 6 months if they were re-treated with bupropion instead of placebo (8 [7%] of 111 vs 0 [0%] of 112; P=.003), and the 209 smokers initially treated with bupropion and re-treated with a nicotine inhaler did not have significantly higher smoking abstinence rates (6 [6%] of 104 vs 3 [3%] of 105; P=.50). CONCLUSION: Combined therapy with a nicotine inhaler and bupropion increased smoking abstinence rates. Continuation of the initial combination therapy does not appear to prevent relapse to smoking. Timing of re-treatment and alternative approaches to relapse prevention should be further examined.


Related Articles

  • Effectiveness of Nicotine Inhaler for Smoking Cessation in an OTC Setting. Leischow, Scott J.; Ranger-Moore, James; Muramoto, Myra L.; Matthews, Eva // American Journal of Health Behavior;Jul/Aug2004, Vol. 28 Issue 4, p291 

    Objective: To evaluate the effectiveness of the Nicotrol® nicotine inhaler as an aid to smoking cessation in over-the-counter (OTC) versus health-care-provider (HCP) conditions. Methods: Five hundred twenty healthy smokers were randomized to the treatment conditions and followed for a year....

  • A meta-analysis of the efficacy of over-the-counter nicotine replacement. Hughes, J.R.; Shiffman, S.; Callas, P.; Zhang, J. // Tobacco Control;Mar2003, Vol. 12 Issue 1, p21 

    Objective: To determine whether over-the-counter (OTC) nicotine replacement therapy (NRT) is pharmacologically efficacious, whether it produces abstinence rates similar to those in prescription settings, and to estimate the long term (that is, greater than six month) abstinence rate with OTC...

  • Nicotine concentrations with concurrent use of cigarettes and nicotine replacement: A review. Fagerström, Karl Olov; Hughes, John R // Nicotine & Tobacco Research;Dec2002 Supplement 2, Vol. 4, p73 

    This paper reviews the data on blood nicotine or saliva cotinine concentrations with concomitant smoking and use of nicotine replacement (NR) products. Eleven studies that provided data on blood nicotine concentrations, carbon monoxide in exhaled air, and number of cigarettes smoked were...

  • CLIP N' POST Eight ways to help you quit smoking. Parachin, Victor M. // American Fitness;Nov/Dec2002, Vol. 20 Issue 6, p52 

    Presents pieces of advice on how to quit smoking. Health effects of smoking; List of possible reasons for quitting smoking; Examples of nicotine replacement products.

  • The place of varenicline in smoking cessation treatment. Aveyard, Paul // Thorax;Aug2008, Vol. 63 Issue 8, p666 

    The article discusses a study which examined the efficacy of varenicline against nicotine replacement therapy. It mentions that bupropion is rarely used in many countries and nicotine replacement therapy is the predominant treatment offered in general practices and in specialist smoking...

  • BEAT YOUR BUTT. Detz, Jeanine // Joe Weider's Muscle & Fitness;Sep2005, Vol. 66 Issue 9, p62 

    Presents information on the Endit nicotine-free inhaler. Benefits of the product compared with other smoking cessation methods; Retail price of the inhaler.

  • Nicorette Inhalor.  // Royal Society of Medicine: Medicines;2002, p390 

    This article presents information on Nicorette inhalor. It is a proprietary non-prescription preparation of nicotine. It can be used to alleviate the withdrawal symptoms experienced when giving up smoking. It is available in the form of an inhalation cartridge.

  • Different strokes for different folks.  // Australian Journal of Pharmacy;Mar2014, Vol. 95 Issue 1126, p14 

    The article features the range of pharmaceutical preparations produced by Nicorette for treating nicotine dependence. Topics discussed include the release of 2 and 4 milligram cooldrop lozenges for addressing cravings and the use of QuickMist mouth spray that provides immediate craving relief....

  • Gender differences in quit rates following smoking cessation with combination nicotine therapy: Influence of baseline smoking behavior. Bohadana, Abraham; Nilsson, Fredrik; Rasmussen, Thomas; Martinet, Yves // Nicotine & Tobacco Research;Feb2003, Vol. 5 Issue 1, p111 

    Investigates whether the male versus female cessation outcome was influenced by baseline smoking behavior in participants who attempted to quit by using nicotine inhaler plus nicotine patch combination therapy. Assessment of baseline nicotine dependence by the Fagerstrom Test for Nicotine...


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics